POS0729 FOOT DISORDERS ASSOCIATED WITH JACCOUD’S ARTHROPATHY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A DESCRIPTIVE STUDY.
Authors: L. Cano Garcia, J. García-Campos, A. Garcia Studer, F. Ortiz-Márquez, G. Diaz-Cordobes, J. Marco-Lledó
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is a chronic disease of autoimmune origin mediated by autoantibodies, affecting various organs 12 . 95% of patients with SLE develop musculoskeletal involvement 1 , most of the time as arthralgia or non-erosive arthritis, mainly affecting the hands and knees. A subgroup of patients with lupus that is seen with increasing frequency, late develops a deforming arthropathy as a result of the laxity of ligaments and peritendinous apparatus that produces a joint subluxation. The foot is a highly affected structure that may initially go unnoticed, but it leads to significant disability. Objectives To know the prevalence of foot problems in a sample of patients with SLE. Methods A cross-sectional study design. Forty-seven subjects with a diagnosis of SLE were consecutively recruited in a Rheumatology Unit between March and May 2021. The inclusion criteria were: patients with a diagnosis of SLE according to the EULAR / ACR 2019 criteria, with at least one year of evolution and age equal to or greater than 18 years. A Rheumatology nurse collected information on socio-demographic data and the characteristics of the feet regarding the musculoskeletal system, skin, appendages, circulatory system and nervous system using a pre-designed questionnaire. The study was approved by the Ethics Committee, following the recommendations of the Declaration of Helsinki and the legal regulations in force in our country regarding clinical research and the current Good Clinical Practice standards. All participants were informed of the objectives and methods of the study and signed the informed consent. Descriptive statistical analysis. Results 47 subjects participated (93.6% women) with a mean age (SD) of 49.2 (10.8) years (range 23-66 years). Thirty-five (74.5%) patients presented a low internal longitudinal arch in one or both feet, 19 (40%) Hallux Abductus Valgus (HAV) and 30 (63.8%) presented alterations in the other toes. Seventeen (36.2%) patients had pain in the hindfoot, 16 (34.0%) in the midfoot, 17 (36.2%) in the forefoot, and 14 (29.8%) in the toes. Stiffness in the feet appeared in 8 (17%) while joint swelling appeared in only one (2.1%). On the skin and appendages: 10 (21.3%) showed nail lesions and 39 (80.3%) presented some dermal lesion of the hyperkeratosis type due to friction or poor support. In the circulatory system there were no findings. Two (4.3%) patients had less bilateral sensitivity in the examination of the nervous system in the feet. Conclusion The most prevalent foot problems affect the musculoskeletal system and are related to Jaccoud arthropathy, especially the sinking of the internal longitudinal arch. Hyperkeratosis associated with poor foot support were also very prevalent. References [1]Cherry L, Alcacer-Pitarch B, Hopkinson N, Teh LS, Vital EM, Edwards CJ, et al. The prevalence of self-reported lower limb and foot health problems experienced by participants with systemic lupus erythematosus: Results of a UK national survey. Lupus. 2017 Apr;26(4):410-416. [2]Durcan L, O’Dwyer T, Petri M. Management strategies and future directions for systemic lupus erythematosus in adults. Lancet. 2019 Jun 8;393(10188):2332-2343. Disclosure of Interests None declared